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- PUBLI ORKS PERMIT �ate: 2/9/20�7 <br /> � F��c Works Permit#: PW1702-021 <br /> City of Everett Public Works Department <br /> - 3200 Cedar Street Parent Permit#: <br /> Everett, WA 98201 Planning Reference#: <br /> (425)257-8810 <br /> Public Works Fee$: $ 65.00 <br /> Other$: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> OUCH NEARY HARRIS JOHN <br /> 1522 BROADWAY 6610 95TH ST NE <br /> EVERETT �/q 98201 MARYSVILLE Wq 98270 <br /> PHONE: 2063071651` PHONE: 3607229161 � <br /> TAX PARCEL ID# 00437936402100 SITE ADDRESS: 1822 BROADWAY� <br /> REPAVE EXISITING REAR YARD <br /> Remove exisitng broken concrete fio rock grade surface, export off site. Surface grade the existing rock course with flow <br /> lines to catch basins. Remove old catch basins and replace with 2 new catch basins. Repave wifih 3" class A asphalt. <br /> Project shall not disturb the exising base course. If base course is disturbed, drainage mitigation requirements may be <br /> triggered. <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made 24 hours in advance. <br /> 2. All work shall be pertormed in accordance with the permit and current City of Everett Design and Construction Standards <br /> and Specifications. <br /> 3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 <br /> 4. Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior �; '��.� <br /> to starting construction and with all other inspection requests. See attached to request �'"}�'�` �; "�+ <br /> an inspection. ��:�±��; ��� W <br /> 5. Install erosion control measures per City of Everett Standards for small parcels and � .-�-.� '�' [� <br /> remove upon completion of the project prior to final approval of the permit. 4'` �� �� M"'{ <br /> 6. Keep City streets clean at all times. No dirt, mud, rocks, or debris to be tracked onto � �., � <br /> roadway. �`"` �'c <br /> 7. Protect all existing underground utilities during construction. r`� � <br /> 8. It is the applicant/owner's responsibility to ensure that stormwater runoff from new � � 0 <br /> impervious surfaces will be managed on-site in a manner that does not adversely affect ,�.; <br /> neighboring properties, including the City's right-of-way and/or easements and the ��,��� . � <br /> i m p r o v e m e n t s l o c a t e d t h e r e i n. �.��r,� O <br /> 9. Stormwater from new impervious surfaces shall not be discharged, through �-- <--�,;�., <br /> �a'�c-....>ca �°� <br /> downspouts or other direct pipe connections, into a combined sewer, including a lateral �;�.,�, �..� <br /> iine or side sewer connected to the city's combined sewer system as per EMC Chapter �,,� � <br /> 14.08.180 H. O <br /> Public Works Permit Fee Breakdown: a <br /> Paving (Asphalt)..............................$45.00 <br /> PW Site Inspection..........................$Z0.00 <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned ownedapplicant hereby agrees to hold and save harmless the <br /> City of Everett from any and all claims for damages,costs,expenses,or <br /> J� causes of action that may arise because of installation and maintenance of the <br /> ` � improvement or other right-of-way use hereto applied for and further agrees to <br /> pproved for Construction Date remove sa e upon n tice from the City and to replace public property <br /> damaged ereby. <br /> FINAL INSPECTION Date �, � �`� <br /> Approved as Constructed Sign re of pplicant Dat <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF E PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY <br /> PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br /> l / l/G- <br />